Analysis of the reasons for difficult intubation of nasogastric tube in neurosurgery patients and nursingcountermeasures
神经外科患者鼻胃管困难置管的原因分析及护理对策

摘要

目的 总结28例神经外科鼻胃管置管困难患者的原因，阐述置管对策，提高临床护士留置鼻胃管的成功率。方法 纳入某三甲医院神经外科2018年9月至2021年06月收治的262例留置鼻胃管患者，对其中28例困难置管患者进行分析。结果 神经外科患者鼻胃管困难置管的原因有意识障碍合并吞咽功能障碍、频繁呛咳、人工气道、舌根后坠、鼻中隔弯曲、水肿等，通过采取个性化的置管策略，28例均置管成功。结论 神经外科病人鼻胃管置入困难的原因是多方面的，置管前充分的评估和准备，根据置管困难的不同原因，个性化的采取置管技巧，能提高神经外科患者的胃管置管成功率，减轻病人的痛苦。

Abstract

Objective To summarize the reasons of 28 patients with difficult indwelling nasogastric tube in neurosurgery, expound the countermeasures of tube placement, and improve the success rate of indwelling nasogastric tube by clinical nurses.
Methods A total of 262 patients with indwelling nasogastric tube who were admitted to the Department of Neurosurgery in a tertiary hospital from September 2018 to June 2021 were included, and 28 patients with difficult tube placement were analyzed.
Results The reasons for difficult nasogastric tube placement in neurosurgery patients were disturbance of consciousness combined with swallowing dysfunction, frequent choking, artificial airway, back of tongue, curvature of nasal septum, edema, etc. By adopting a personalized tube placement strategy, all 28 patients were placed Tube success.
Conclusion   There are many reasons for the difficulty of nasogastric tube placement in neurosurgery patients. Adequate assessment and preparation before tube placement, and individualized adoption of tube placement skills according to the different reasons for the difficulty of tube placement can improve the gastric tube placement in neurosurgery patients. The success rate of intubation can reduce the pain of patients.